Study of pulmonary function tests in Type 2 Diabetes Mellitus and their correlation with glycemic control and systemic inflammation

Introduction: Reduced lung function in diabetes has been described for long but its clinical importance is not yet clear. Also, limited literature is available regarding its association with sugar control, and its correlation with inflammatory markers. Thus, we aimed to study the pulmonary function test abnormalities and systemic inflammation in type 2 diabetes mellitus. Material and methods: 100 patients with type 2 diabetes were divided into two groups depending on control of diabetes (group A–HbA1C ≤ 7% and group B-HbA1C > 7%). All the subjects selected underwent detailed evaluation including testing for HbA1C, HsCRP (high-sensitivity C-reactive protein), serum ferritin and serum fibrinogen, along with pulmonary function testing. Results: Percentage predicted FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 second) and SVC (slow vital capacity) were significantly reduced, while mean values of inflammatory markers [fibrinogen (p < 0.001) and hsCRP (p < 0.002)] were significantly higher in uncontrolled diabetes group. There was a significant negative correlation between FEV1 (r = –0.739, p < 0.001), FVC (r = –0.370, p < 0.001), SVC (r = –0.635, p < 0.001) with HbA1C. HbA1C had a positive correlation with hsCRP (r = –0.308, p < 0.002) and fibrinogen (r = 0.388, p < 0.001). Conclusion: Pulmonary functions were decreased and inflammatory markers like hsCRP, fibrinogen, and ferritin significantly increased in uncontrolled diabetics. Also, a potential association was seen between higher values of inflammatory markers like hsCRP and fibrinogen and decrease in lung function. This information, requiring confirmation with larger multicentre studies, remains important because of potential epidemiological, clinical and therapeutic implications

Different Faces of HIV in a Single Patient

Opportunistic infections (OIs) are a major cause of morbidity and mortality in patients with human immunodeficiency virus (HIV) infection. The most common opportunistic infection is tuberculosis, followed by candidiasis, infections causing diarrhoea, and pneumocystis carinii pneumonia (PCP). We hereby report the case of a 34-year-old male with clinical stage-IV acquired immunodeficiency syndrome (AIDS) who had multiple OIs including visceral leishmaniasis (VLs) an uncommon co-infection in the Indian scenario. This patient also had features of multiple pulmonary infections-bacterial, mycobacterial and fungal, a rare clinical problem in HIV

Parametry czynności układu oddechowego u chorych na cukrzycę typu 2 i ich korelacja z kontrolą glikemii i zapaleniem systemowym

WSTĘP: Obniżone parametry czynności płuc u chorych na cukrzycę to zjawisko opisywane od wielu lat, ale kliniczne znaczenie tego faktu nie zostało dotychczas wyjaśnione. Piśmiennictwo dotyczące związku tego zjawiska z kontrolą glikemii i markerami zapalenia jest bardzo ubogie. Celem badania była ocena występowania zaburzeń czynności płuc i zapalenia systemowego u chorych na cukrzycę typu 2. MATERIAŁ I METODY: Chorych na cukrzycę typu 2 (n = 100) podzielono na dwie grupy w zależności od poziomu kontroli cukrzycy (grupa A — HbA1C ≤ 7% i grupa B — HbA1C &gt; 7%). U wszystkich chorych przeprowadzono badanie hemoglobiny glikowanej (HbA1C), stężenia białka C-reaktywnego (hsCRP), ferrytyny i fibrynogenu w surowicy oraz wykonano badanie spirometryczne. WYNIKI: W grupie chorych z niekontrolowaną cukrzycą wartości natężonej pojemności życiowej (FVC), natężonej objętości wydechowej w 1 sekundzie wydechu (FEV1) i wolnej pojemności życiowej (SVC) wyrażonych w procentach wartości należnej były znamiennie niższe, a średnie stężenia parametrów zapalenia systemowego (fibrynogenu, p &lt; 0,001 oraz hsCRP, p &lt; 0,002) znamiennie wyższe. Wykazano negatywną korelację pomiędzy wartością FEV1 (r = –0,739, p &lt; 0,001), FVC (r = –0,370, p &lt; 0,001), SVC (r = –0,635, p &lt; 0,001) a stężeniem HbA1C. Z kolei stężenie HbA1C korelowało dodatnio ze stężeniem hsCRP (r = –0,308, p &lt; 0,002) i fibrynogenu (r = 0,388, p &lt; 0,001). WNIOSKI: Parametry czynności płuc były obniżone a stężenia markerów zapalenia, takich jak hsCRP, fibrynogenu i ferrytyny znamiennie wyższe u chorych z niekontrolowaną cukrzycą. Ponadto stwierdzono związek pomiędzy wysokimi stężeniami markerów zapalenia i obniżonymi parametrami czynności płuc. Uzyskane wyniki, choć wymagają potwierdzenia w większych badaniach wieloośrodkowych, mają ważne implikacje epidemiologiczne, kliniczne i terapeutyczne.WSTĘP: Obniżone parametry czynności płuc u chorych na cukrzycę to zjawisko opisywane od wielu lat, ale kliniczne znaczenie tego faktu nie zostało dotychczas wyjaśnione. Piśmiennictwo dotyczące związku tego zjawiska z kontrolą glikemii i markerami zapalenia jest bardzo ubogie. Celem badania była ocena występowania zaburzeń czynności płuc i zapalenia systemowego u chorych na cukrzycę typu 2. MATERIAŁ I METODY: Chorych na cukrzycę typu 2 (n = 100) podzielono na dwie grupy w zależności od poziomu kontroli cukrzycy (grupa A — HbA1C ≤ 7% i grupa B — HbA1C > 7%). U wszystkich chorych przeprowadzono badanie hemoglobiny glikowanej (HbA1C), stężenia białka C-reaktywnego (hsCRP), ferrytyny i fibrynogenu w surowicy oraz wykonano badanie spirometryczne. WYNIKI: W grupie chorych z niekontrolowaną cukrzycą wartości natężonej pojemności życiowej (FVC), natężonej objętości wydechowej w 1 sekundzie wydechu (FEV1) i wolnej pojemności życiowej (SVC) wyrażonych w procentach wartości należnej były znamiennie niższe, a średnie stężenia parametrów zapalenia systemowego (fibrynogenu, p < 0,001 oraz hsCRP, p < 0,002) znamiennie wyższe. Wykazano negatywną korelację pomiędzy wartością FEV1 (r = –0,739, p < 0,001), FVC (r = –0,370, p < 0,001), SVC (r = –0,635, p < 0,001) a stężeniem HbA1C. Z kolei stężenie HbA1C korelowało dodatnio ze stężeniem hsCRP (r = –0,308, p < 0,002) i fibrynogenu (r = 0,388, p < 0,001). WNIOSKI: Parametry czynności płuc były obniżone a stężenia markerów zapalenia, takich jak hsCRP, fibrynogenu i ferrytyny znamiennie wyższe u chorych z niekontrolowaną cukrzycą. Ponadto stwierdzono związek pomiędzy wysokimi stężeniami markerów zapalenia i obniżonymi parametrami czynności płuc. Uzyskane wyniki, choć wymagają potwierdzenia w większych badaniach wieloośrodkowych, mają ważne implikacje epidemiologiczne, kliniczne i terapeutyczne

Chemical examination of Artabotrys odoratissimus (leaves)

618-62

To evaluate the efficacy of ropivacaine with dexmedetomidine and ropivacaine with dexamethasone in fascia iliaca compartment block for post-operative pain relief in fracture femur surgeries: A comparative randomized study

Background: Patients with femur fracture experience severe post-operative pain. Fascia iliaca compartment block (FICB) is a safe and effective approach for providing post-operative analgesia. Aims and Objectives: The aim of the study was to compare the post-operative pain relief with dexmedetomidine and dexamethasone with ropivacaine in FICB. Materials and Methods: This prospective, double-blinded, randomized controlled, and clinical study was done on 105 patients, with ASA physical status I-II, aged between 18 and 70 years, undergoing surgery for femur fracture. Patients were randomly allocated into three groups. All patients received FICB by landmark technique before spinal anesthesia. Group A patients received 38 mL of 0.25% ropivacaine and dexmedetomidine, Group B received 38 mL of 0.25% ropivacaine and dexamethasone and Group C received 38 mL of 0.25% ropivacaine. Patients were assessed for analgesia during positioning and post-operative period using visual analog scale (VAS). Hemodynamic parameters and time for first rescue analgesia were recorded. Results: The mean VAS score at 6 h after surgery was 0.74±0.95 in Group A, in Group B 2.26±0.95, and in Group C was 4.23±1.17, which was statistically significant (P<0.05). The time for first rescue analgesia was 13.03±1.79 h in Group-A, 8.31±1.11 h in Group B and 5.94±0.87 h in Group C (P<0.001). Conclusion: Addition of dexmedetomidine or dexamethasone to ropivacaine for FICB in femur fracture patients prolongs post-operative analgesia compared to ropivacaine alone

Quasi-Elastic Scattering in the Inclusive (3^3He, t) Reaction

The triton energy spectra of the charge-exchange $^{12}$C($^3$He,t) reaction at 2 GeV beam energy are analyzed in the quasi-elastic nucleon knock-out region. Considering that this region is mainly populated by the charge-exchange of a proton in $^3$He with a neutron in the target nucleus and the final proton going in the continuum, the cross-sections are written in the distorted-wave impulse approximation. The t-matrix for the elementary exchange process is constructed in the DWBA, using one pion- plus rho-exchange potential for the spin-isospin nucleon- nucleon potential. This t-matrix reproduces the experimental data on the elementary pn $\rightarrow$np process. The calculated cross-sections for the $^{12}$C($^3$He,t) reaction at $2^o$ to $7^o$ triton emission angle are compared with the corresponding experimental data, and are found in reasonable overall accord.Comment: 19 pages, latex, 11 postscript figures available at [email protected], submitted to Phy.Rev.

Growth of cosmic structure:probing dark energy beyond expansion

The quantity and quality of cosmic structure observations have greatly accelerated in recent years, and further leaps forward will be facilitated by imminent projects. These will enable us to map the evolution of dark and baryonic matter density fluctuations over cosmic history. The way that these fluctuations vary over space and time is sensitive to several pieces of fundamental physics: the primordial perturbations generated by GUT-scale physics; neutrino masses and interactions; the nature of dark matter and dark energy. We focus on the last of these here: the ways that combining probes of growth with those of the cosmic expansion such as distance-redshift relations will pin down the mechanism driving the acceleration of the Universe. One way to explain the acceleration of the Universe is invoke dark energy parameterized by an equation of state w. Distance measurements provide one set of constraints on w, but dark energy also affects how rapidly structure grows; the greater the acceleration, the more suppressed the growth of structure. Upcoming surveys are therefore designed to probe w with direct observations of the distance scale and the growth of structure, each complementing the other on systematic errors and constraints on dark energy. A consistent set of results will greatly increase the reliability of the final answer. Another possibility is that there is no dark energy, but that General Relativity does not describe the laws of physics accurately on large scales. While the properties of gravity have been measured with exquisite precision at stellar system scales and densities, within our solar system and by binary pulsar systems, its properties in different environments are poorly constrained. To fully understand if General Relativity is the complete theory of gravity we must test gravity across a spectrum of scales and densities. Rapid developments in gravitational wave astronomy and numerical relativity are directed at testing gravity in the high curvature, high density regime. Cosmological evolution provides a polar opposite test bed, probing how gravity behaves in the lowest curvature, low density environments. There are a number of different implementations of astrophysically relevant modifications of gravity. Generically, the models are able to reproduce the distance measurements while at the same time altering the growth of structure. In particular, as detailed below, the Poisson equation relating over-densities to gravitational potentials is altered, and the potential that determines the geodesics of relativistic particles (such as photons) differs from the potential that determines the motion of non-relativistic particles. Upcoming surveys will exploit these differences to determine whether the acceleration of the Universe is due to dark energy or to modified gravity. To realize this potential, both wide field imaging and spectroscopic redshift surveys play crucial roles. Projects including DES, eBOSS, DESI, PFS, LSST, Euclid, and WFIRST are in line to map more than a 1000 cubic-billion-light-year volume of the Universe. These will map the cosmic structure growth rate to 1% in the redshift range 0<2, over the last 3/4 of the age of the Universe